Provider Demographics
NPI:1689739047
Name:PALMER, MICHAEL V (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:V
Last Name:PALMER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ROUTE 130 S
Mailing Address - Street 2:MADISON BUILDING, SUITE 321
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-2845
Mailing Address - Country:US
Mailing Address - Phone:856-829-3385
Mailing Address - Fax:856-829-8985
Practice Address - Street 1:101 ROUTE 130 S
Practice Address - Street 2:MADISON BUILDING, SUITE 321
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-2845
Practice Address - Country:US
Practice Address - Phone:856-829-3385
Practice Address - Fax:856-829-8985
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00305000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health